Treatment of corneal dermoid with fibrin glue boned multi-layer lenticules derived from SMILE surgery

Abstract

Purpose Dermoid resection combined with lamellar keratoplasty was one of the most common surgical techniques for corneal dermoid. The aim of this preliminary study was to investigate the safety and feasibility of FG boned SMILE-derived multi-layer lenticules as corneal grafts to treat corneal dermoid. Methods 5 patients with corneal dermoid were involved in this study. All patients were treated with dermoid resection combined with FG boned multi-layer corneal lenticules transplantation. Ocular appearance, corneal grafts’ growth, location, epithelialization, transparency, and limbal pannus were assessed using slit lamp microscopy and anterior-segmental optical coherence tomography. The change of best-corrected visual acuity (BCVA) and astigmatism were examined preoperatively and postoperatively. Results Total of 5 patients were satisfied with the postoperative ocular appearance. All FG boned multi-layer lenticules grafts were successfully adhered to the corneal beds, without any dislocation or Interlayer separation. The lenticule grafts grew well and kept transparent during the follow-up time. Corneal epithelialization was observed in one week after transplantation, with smooth corneal epithelial coverage on the corneal surface, meanwhile, the grafts gradually merged with the recipient corneal stroma after 1mo post-operation. BCVA had been statistically improved from 0.36 ± 0.21 to 0.76 ± 0.17 in decimal at 3mo post-operation (Z=-2.060, P = 0.039). Postoperative corneal astigmatism also had been statistically decreased from 2.65 ± 0.42 D to 1.25 ± 0.18 D at 3mo postoperative (Z=-2.023, P = 0.043). Conclusion FG boned multi-layer lenticules would be the novel and feasible substitute for lamellar keratoplasty in the treatment of corneal dermoid. FG could not be only used as binder adhering multi-layer lenticules, closing the interlayer space of multi-layer lenticules, preventing the formation of interlayer fluid, but also increasing the thickness and toughness of lenticules, and therefore which is more facilitate to intraoperative suture.